Reduced Vancomycin Susceptibility in Staphylococcus aureus, Including Vancomycin-Intermediate and Heterogeneous Vancomycin-Intermediate Strains: Resistance Mechanisms, Laboratory Detection, and Clinical Implications
Benjamin P Howden,John K. Davies,Paul D R Johnson,Paul D R Johnson,Timothy P. Stinear,Timothy P. Stinear,M Lindsay Grayson,M Lindsay Grayson +7 more
TLDR
It is now becoming clear that sequential point mutations in key global regulatory genes contribute to the hVISA and VISA phenotypes, which are associated predominately with cell wall thickening and restricted vancomycin access to its site of activity in the division septum.Abstract:
The emergence of vancomycin-intermediate Staphylococcus aureus (VISA) and heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) over the past decade has provided a challenge to diagnostic microbiologists to detect these strains, clinicians treating patients with infections due to these strains, and researchers attempting to understand the resistance mechanisms. Recent data show that these strains have been detected globally and in many cases are associated with glycopeptide treatment failure; however, more rigorous clinical studies are required to clearly define the contribution of hVISA to glycopeptide treatment outcomes. It is now becoming clear that sequential point mutations in key global regulatory genes contribute to the hVISA and VISA phenotypes, which are associated predominately with cell wall thickening and restricted vancomycin access to its site of activity in the division septum; however, the phenotypic features of these strains can vary because the mutations leading to resistance can vary. Interestingly, changes in the staphylococcal surface and expression of agr are likely to impact host-pathogen interactions in hVISA and VISA infections. Given the subtleties of vancomycin susceptibility testing against S. aureus, it is imperative that diagnostic laboratories use well-standardized methods and have a framework for detecting reduced vancomycin susceptibility in S. aureus.read more
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Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management
TL;DR: This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of S. aureus as a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections.
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Mechanisms of Antibiotic Resistance
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TL;DR: This chapter will describe in detail the major mechanisms of antibiotic resistance encountered in clinical practice, providing specific examples in relevant bacterial pathogens.
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Coagulase-Negative Staphylococci
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Predictors of Mortality in Staphylococcus aureus Bacteremia
Sebastian Van Hal,Slade O. Jensen,Slade O. Jensen,Vikram L. Vaska,Björn A. Espedido,Björn A. Espedido,David L. Paterson,Iain B Gosbell,Iain B Gosbell +8 more
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Antimicrobial resistance in ESKAPE pathogens
David M. P. De Oliveira,Brian M. Forde,Timothy J. Kidd,Patrick N A Harris,Mark A. Schembri,Scott A. Beatson,David L. Paterson,Mark J. Walker +7 more
TL;DR: The acquisition of antimicrobial resistance genes by ESKAPE pathogens has reduced the treatment options for serious infections, increased the burden of disease, and increased death rates due to treatment failure and requires a coordinated global response for antim antibiotic resistance surveillance.
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